SLIDE 7 1/29/2013 7
Board of Medicine: OAC 4731‐11‐03
Schedule II controlled substance stimulants.
- (C) A physician may utilize a schedule II controlled substance stimulant when
properly indicated for any purpose listed in paragraph (A) of this rule, provided that all of the following conditions are met:
- (1) Before initiating treatment utilizing a schedule II controlled substance stimulant,
the physician obtains a thorough history, performs a thorough physical examination of the patient, and rules out the existence of any recognized contraindications to the use
- f the controlled substance stimulant to be utilized.
- (2) The physician shall not utilize any schedule II controlled substance stimulant when
he knows or has reason to believe that a recognized contra‐indication to its use exists.
- (3) The physician shall not utilize any schedule II controlled substance stimulant in
the treatment of a patient who he knows or should know is pregnant.
- (4) Upon ascertaining or having reason to believe that the patient has a history of or
shows a propensity for alcohol or drug abuse, or that the patient has consumed or disposed of any controlled substance other than in strict compliance with the treating physician’s directions, the physician shall reappraise the desirability of continued utilization of schedule II controlled substance stimulants and shall document in the patient record the factors weighed in deciding to continue their use. The physician shall actively monitor such a patient for signs and symptoms of drug abuse and drug dependency.
Board of Medicine: OAC 4731‐11‐09
Prescribing to persons not seen by the physician.
- (A) Except in institutional settings, on call situations, cross
coverage situations, situations involving new patients, protocol situations, situations involving nurses practicing in accordance with standard care arrangements, and hospice settings, as described in paragraphs (D) and (E) of this rule, a physician shall not prescribe, dispense, or otherwise provide,
- r cause to be provided, any controlled substance to a
person who the physician has never personally physically examined and diagnosed.
- NOTE: This applies to APRNs.
Board of Medicine: OAC 4731‐11‐09
Prescribing to persons not seen by the physician.
- (E) Paragraphs (A) and (B) of this rule do not apply to or prohibit if:
- (1) The provision of controlled substances or dangerous drugs by a physician to a
person who is a patient of a colleague of the physician, if the drugs are provided pursuant to an on call or cross coverage arrangement between the physicians;
- (2) The provision of controlled substances or dangerous drugs by a physician to a
person who the physician has accepted as a patient, if the physician has scheduled or is in the process of scheduling an appointment to examine the patient and the drugs are intended to be used pending that appointment;
- (3) The provision of controlled substances or dangerous drugs by emergency
medical squad personnel, nurses, or other appropriately trained and licensed individuals, in accordance with protocols approved by the state board of pharmacy pursuant to rule 4729‐5‐01 of the Administrative Code; or
- (5) The provision of controlled substances or dangerous drugs by a physician who
is a medical director or hospice physician of a hospice program licensed pursuant to Chapter 3712. of the Revised Code, to a patient who is enrolled in that hospice program.
Board of Nursing: OAC 4723‐8‐04 Standard care
arrangement for a certified nurse‐midwife, certified nurse practitioner, and clinical nurse specialist.
- (12) For nurses with a current valid certificate to prescribe, the following quality
assurance provisions shall be included (in the SCA):
- (a) Provisions to ensure timely direct, personal evaluation of the patient with a
collaborating physician or the physician’s designee when indicated;
- (b) Additional prescribing parameters for those drugs or therapeutic devices
established in the formulary, including:
- (i) Provisions for use of drugs with non‐food and drug administration (FDA) approved
indications;
- (ii) Provisions for use of drugs approved by the FDA and reviewed by the committee on
prescriptive governance subsequent to the date of the standard care arrangement; and
- (iii) Provisions for use of drugs previously reviewed by the committee on prescriptive
governance but approved by the FDA for new indications subsequent to the date of the standard care arrangement.; and
- (iv) Provisions for the use of schedule II controlled substances.
- Comment: What your collaborating MD authorizes
- Examples:
- May prescribe all opioids approved by CPG.
- May prescribe all schedule II controlled substances approved by CPG.
- May only prescribe oral opioids.
- No schedule II controlled substances authorized.
Board of Nursing: OAC 4723‐8‐04 Standard care
arrangement for a certified nurse‐midwife, certified nurse practitioner, and clinical nurse specialist.
- (12) For nurses with a current valid certificate to prescribe, the following
quality assurance provisions shall be included (in the SCA) :
- (c) A procedure for the nurse and the collaborating physician, or a designated
member of a quality assurance committee, composed of physicians, of the institution, organization, or agency where the nurse has practiced during the period covered by the review, to conduct a periodic review, at least semiannually, of:
- (i) A representative sample of all prescriptions written by the nurse; and
- (ii) A representative sample of all schedule II prescriptions written by the nurse;
- (d) Provisions to ensure that the nurse is meeting all the requirements of
rule 4723‐9‐12 of the Administrative Code related to review of a patient’s OARRS report, consultation with the collaborating physician prior to prescribing based on the OARRS report and signs of drug abuse or diversion described in paragraph (B) of rule 4723‐9‐12, and documentation of receipt and assessment of OARRS report information in the patient’s record.
Board of Nursing: OAC 4723‐9‐07 Certificate to
Prescribe Renewal
- A) To renew a certificate to prescribe, (APN) shall submit:
- (1) A completed renewal application on a form specified by the
board;
- (2) Documentation satisfactory to the Board of having completed
during the previous two years at least twelve hours of additional continuing education in advanced pharmacology, as provided in section 4723.485 of the Revised Code, which includes instruction that is specific to controlled substances, or, if the certificate has been held for less than a full renewal period, at least six hours of approved continuing education in pharmacology as provided in section 4723.485 of the Revised Code, which includes instruction specific to controlled substances;
- Comment: Suggest a specific CE on controlled substances.
- Note: The 12 hours of pharmacology CE are in addition to the
24 hours of CE required for RN/COA renewal.
